Pediatric Concussion Management in the ER and Primary Care Settings

Mild traumatic brain injuries, also identified as concussions, are serious head injuries that can influence the ability of the brain to function at its normal capacity. According to the Center for Disease Control and Prevention (CDC), traumatic brain injuries are a major cause of death and disability in the United States, contributing to approximately 30% of all injury deaths, and almost half a million children under the age of nineteen years of age visit the emergency department due to a concussion yearly in the United States. Reported pediatric concussions due to sports and recreation related injuries has doubled over the last 10 years. A new study observing children’s brains post-concussion found troubling evidence that improperly managed concussions can lead to long-term effects from a head injury, affecting cognitive defects and mental health problems, even after symptoms subside. Prior to 2018, no broad, evidence-based clinical guidelines were developed in the United States for the purposes of diagnosis, prognosis, management and treatment of pediatric concussions. This poster presents the typical presentation of concussions in children in the Pediatric Emergency Department and Primary Care settings, signs and symptoms to monitor, concussion management and prevention measures, as well as the 2018 CDC guidelines on the diagnosis and management of concussions among children. Bridging of the education gap between concussion care in the Pediatric Emergency Department and Primary Care setting is necessary for the concussion patient’s continuity of care in order to ensure successful outcomes of healing. Methods to educate parents on in home monitoring their child’s concussion symptoms is also reviewed. Application of the 2018 CDC guidelines on pediatric concussion management calls for changes in the way concussion care has previously been addressed. It is vital for Pediatric Nurse Practitioners, nurses and all health care clinicians to recognize and understand current evidence-based recommendations for concussion management in this vulnerable pediatric population.